Does nibbling or grazing protect the peripheral arteries from atherosclerosis?

Background It has been suggested that frequent food intake is metabolically advantageous. We investigated whether meal frequency was associated with t he development of peripheral arterial disease among smokers. Design Hospital-based case-control study of smokers, recruited from outpati ent clinics and inpatient wards at two London teaching hospitals. Methods Two-hundred and ninety-one smokers, newly referred with peripheral arterial disease (cases) and 828 age- and sex-matched smokers without smoki ng-related disorders and with negative Rose questionnaire responses for int ermittent claudication (controls) were recruited. All cases and controls co mpleted a validated questionnaire concerning dietary habits. Odds ratios fo r peripheral arterial disease in association with several dietary variables were calculated, after adjustment for confounding variables. Results After adjustment for age, sex, pack-years of smoking, diabetes, hyp ertension and body mass index, the odds ratio for peripheral arterial disea se among those smokers eating between meals (grazing) compared with those w ho did not, was 0.54 (95% confidence interval 0.42-0.83; P < 0.001). Among cases and controls, grazing was also associated with significantly lower pl asma cholesterol concentrations (median 5.67 mmol/l in grazers compared wit h 6.08 mmol/l in non-grazers; P < 0.001) in those with apparently similar o verall fat intakes. Neither plasma lipoprotein(a) nor fibrinogen concentrat ions varied with meal frequency. Conclusions In smokers, grazing was associated with a reduced risk of devel oping symptomatic peripheral atherosclerosis. This is the first study to de monstrate the apparent benefits of grazing on a cardiovascular end-point. J Cardiovasc Risk 6:19-22 (C) 1999 Lippincott Williams & Wilkins.